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Background
Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Many people with PTSD
repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. People with PTSD
also experience emotional numbness and sleep disturbances, depression, anxiety,
and irritability or outbursts of anger. Feelings of intense guilt are also common. Physical symptoms such as headaches, gastrointestinal distress, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common in people with PTSD.
In 2004, the Veterans Administration (VA) and the Department of Defense (DoD) developed a clinical practice guideline designed to assist primary care providers in an ambulatory care setting evaluate and manage patients with PTSD. The guideline was revised in 2010:
VA/DoD Clinical Practice Guideline for Management of Post Traumatic Stress, Oct 10. The PTSD CPG is one of the supporting guidelines for the
DoD/VA Clinical Practice Guideline for Post-Deployment Health Evaluation and Management (PDH-CPG), Dec 01, which was developed to assist primary care providers in evaluating and providing care for
individuals with potentially deployment-related health concerns and conditions.
The DoD Deployment Health Clinical Center has developed an intensive, three-week, multi-disciplinary treatment program, The Specialized Care Program (SCP) Track II, for service members experiencing PTSD or
difficulties re-adjusting to life upon redeployment after service in OEF/OIF. The SCP is for patients who have had other treatments for PTSD (or perhaps depression) but continue to experience symptoms that interfere with functioning. It is also for patients who have no other treatment available to them.
Table of Contents
Clinical Guidance
- Borden Institute Text Book of Military Medicine, Combat and Operational Behavioral Health, 2011 (Covers all aspects of behavioral health in the military population, including traumatic brain injury, posttraumatic stress syndrome, combat and operational stress control, training for resiliency and other preventive measures, pain management, grief, family dynamics, rehabilitation and occupational therapy, medications, suicide prevention, forensic psychiatry, detainee care, substance abuse, eating disorders, ethics, and the roles of military behavioral health providers and chaplains, as well as the military's evolving behavioral health policy and practices.)
- A Guide to Guidelines for the Treatment of PTSD and Related Conditions, Journal of Traumatic Stress, Vol. 23, No. 5, October 10, pp. 537–552 (A discussion of 7 clinical practice guidelines for PTSD with the aim of helping clinicians of all disciplines understand the content and usefulness of the guidelines and why there might be discrepancies or inconsistencies among them.)
- VA/DoD Clinical Practice Guideline for Management of Post-Traumatic Stress Disorders, Oct 10
- DoD/VA Clinical Practice Guideline for Post-Deployment Health Evaluation and Management, Dec 01
- VA National Center for PTSD (NCPTSD)
- Institute of Medicine (IOM) of the National Academies
- Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), PTSD Treatment Options
- American Psychiatric Association, Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder, Nov 04
- American Psychological Association Practice Update, Clinical Conversation on Treating Post-Traumatic Stress Disorder (PTSD) Related to Military Combat, 14 Feb 08
- International Society for Traumatic Stress Studies, Effective Treatments for PTSD, Second Edition, 2009
- Center for the Study of Traumatic Stress Fact Sheet, Evidence-Based Management of Posttraumatic Stress Disorder (PTSD)
Policies and Directives
Implementation Guidelines
Implementation Tools
Other Related Information
- TRICARE Management Activity Report to Congress on Independent Study on Post-Traumatic Stress Disorder (PTSD) Efforts, 29 Jan 13 (In response to section 726 of the National Defense Authorization Act for FY 2010 (Public Law 111-84), this report is a response to Phase I of a two-part study completed by the Institute of Medicine in July 2012 on DoD's efforts to address post-traumatic stress disorder (PTSD). )
- Under Secretary of Defense (P&R) Report to Congress, Report on Research and Treatment of PTSD, 17 Dec 12 (In response to section 723 of the National Defense Authorization Act for FY 2012 (Public Law 112-81), this report presents an assessment of neuroimaging research for the purpose of improving the identification and diagnosis of post-traumatic stress disorder (PTSD).)
- Psychological Health and Traumatic Brain Injury, Military Medicine, Supplemental Issue Vol. 177, No. 8S, Aug 12
- Congressional Budget Office (CBO) Study,The Veterans Health Administration's Treatment of PTSD and Traumatic Brain Injury Among Recent Combat Veterans, Feb 12 (This study examines the clinical care provided for recent combat veterans by the Veterans Health Administration (VHA); VHA's coordination with the Department of Defense for the care of service members returning from Iraq and Afghanistan; the prevalence of PTSD and TBI among those veterans and the occurrence of those conditions among recent combat veterans using VHA's services; and the costs to VHA of providing care to recent combat veterans for those conditions.)
- Under Secretary of Defense (P&R) Report to Congress, Study on Treatment of SMs of the Active and Reserve Component for PTSD, 20 Jan 12 (This report presents an overview and assessment of the effectiveness of current outreach, prevention, and treatment programs for PTSD in Service members and their families and as assessment of barriers and other factors that deter Service members from seeking and receiving treatment.)
- RAND Corporation Technical Report, Programs Addressing Psychological Health and Traumatic Brain Injury Among U.S. Military Servicemembers and Their Families, 2011 (First comprehensive catalog of programs sponsored or funded by the Department of Defense to aid military members and their families with psychological health or traumatic brain injury issues.)
- Special Issue: Strengthening Our Soldiers (SOS) and Their Families: Contemporary Psychological Advances Applied to Wartime Problems, Journal of Clinical Psychology in Medical Settings, Vol 18, No 2, Jun 11 Abstract
- GAO Report 11-32 VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services, Jan 11
- IL 10-2010-016, Department of Veterans Affairs, Under Secretary for Health’s Information Letter, Initial Post-traumatic Stress Disorder Examination Changes, 14 Oct 10
- Naval Center for Combat and Operational Stress, Article entitled Can a Veteran Go into Law Enforcement After a PTSD Diagnosis? Law Enforcement's View of Hiring Veterans with PTSD, 2008,
- RAND Report: Invisible Wounds of War, Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery, 2008
Education and Training
- Healthcare Provider
- VA/DoD Satellite Broadcast "VA/DoD Clinical Practice Guideline for PTSD: Integrating the Clinical Practice for PTSD in Primary Care", 2 Oct 12
- RESPECT-Mil (RESPECT-Mil, which stands for Re-Engineering Systems of Primary Care Treatment in the Military, is a system of primary care designed to enhance the recognition and high-quality management of Post-Traumatic Stress Disorder (PTSD) and depression. The US Army Medical Command has directed wide implementation of RESPECT-Mil in Army primary care facilities. Tri-service implementation is in the planning stages. Web-based training for the program is available at this Web site.)
- Massachusetts General Hospital Psychiatry Academy, From the War Zone to the Home Front: Supporting the Mental Health of Veterans and Families 23 Feb 12 - 24 May 13 (14-part series of on-demand, free, CME-certified educational series to assist community primary care and mental health providers in the diagnosis and treatment of the PTSD and TBI in returning veterans and their families.)
- DCoE Complementary and Alternative Medicines (CAM), Modalities and Interventions Fact Sheet, 4 Feb 13
- VA Guideline Briefing: VA/DoD Clinical Practice Guideline for Management of Post-Traumatic Stress Update 2010
- VA National Center for PTSD For Provider and Researcher Web Page
- TRICARE Pilot Education Program for Civilian Providers on PTSD and TBI (Offers 17 Continuing Education Units. Direct care providers can take advantage of this CME educational opportunity through their existing MHS Learn accounts.)
- Performance in Practice: Clinical Tools to Improve the Care of Patients with Posttraumatic Stress Disorder, Focus – The Journal of Lifelong Learning in Psychiatry, Spring 2009; 7: 186-203 (Published by the American Psychiatric Institute for Research and Education. Free – 5 hours of CME credit for completing the PIP survey.)
- Treating the Invisible Wounds of War Online Course Series, Citizen-Soldier Support Program (CSSP), University of North Carolina (To prepare civilian providers to address post-deployment issues facing OIF/OEF veterans and their families, CSSP has partnered with the Veterans Integrated Service Network 6, Mental Illness Research Education and Clinical Center (VISN 6 MIRECC) and the North Carolina Area Health Education Centers (AHEC) to create these online courses for PTSD & TBI. Each course offer continuing education credits, depending upon course material.)
- Military Health System Clinical Quality Management (MHS-CQM) (formerly NQMP)
- VA, Veterans Health Initiative, Independent Study Course, PTSD: Implications for Primary Care, Mar 02
- MedlinePlus:Post Traumatic Stress Disorder Page
- Center for Deployment Psychology (The CDRP located at the Uniformed Services University of the Health Sciences was developed to promote the education of psychologists and other behavioral health specialists about issues pertaining to the deployment of military personnel.)
- Assistant Secretary of Defense (Health Affairs) Memorandum, Guidance for Mental Health Provider Training for the Treatment of Post-Traumatic Stress Disorder and Acute Stress Disorder, 13 Dec 10
- Servicemember/Family
Research
- Institute of Medicine (IOM) Consensus Study, Assessment of Ongoing Efforts in the Treatment of PTSD, Sep 10 (The IOM will convene a committee to conduct a 48 month study of ongoing efforts in the treatment of PTSD. The study will be conducted in 2 phases: Phase 1 will focus on data gathering and will result in the initial study; Phase 2 will focus on the analysis of data and result in an updated study.)
- VA National Center for PTSD (NCPTSD) PTSD Research Quarterly (RQ) (Each RQ contains a review article written by guest experts on a specific topic related to PTSD.)
- Department of Veterans Affairs Health Services Research and Development Service, The Assessment and Treatment of Individuals with History of Traumatic Brain Injury and Post-Traumatic Stress Disorder: A Systematic Review of the Evidence, Aug 09
- Mental Health Advisory Team (MHAT) Reports I,II,III,IV,V, and VI
- Institute of Medicine Report, Treatment of PTSD: An Assessment of The Evidence, Released 17 Oct 07
- GAO Report 06-397, Post-Traumatic Stress Disorder - DoD Needs to Identify the Factors Its Providers Use to Make Mental Health Evaluation Referrals for Servicemembers, May 2006
- National Quality Management Program (NQMP), Post-Deployment Post-Traumatic Stress Disorder (PTSD) Special Study Fact Sheet, 2006
- South Texas Research Organizational Network Guidling Studies on Trauma and Resilience (STRONG STAR)
- Center for the Study of Traumatic Stress (CSTS)
- The International Society for Traumatic Stress Studies
- European Society for Traumatic Stress Studies (ESTSS)
Related Links
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